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CD4 Abnormally High
Jul 23, 2001

Dr. Pavia, as a participant in an IL-2 clinical trial I have seen my T-cells jump from, and this is not a lie, 230/12 to 1666/64. I even went on a STI for 30 days but started back on Sustivia and Combivir when my viral load jumped to 75K. Can a person have to many CD4 cells?

Response from Dr. Pavia

That is a great question, but I don't have a definitive answer. I don't know of any reason that an abnormally high NUMBER of T cells would be harmful, as long as they are derived from normal cells, which is the case in IL-2 use. There are rare T-cell leukemias and lymphomas, where there are an abnormal number of T cells but they are malignant (cancer) cells. There have been, to my knowledge, no ill effects of IL-2 related to increased T cell numbers and no reports of the development of malignancies. The side effects, which you know well, are related to the drug itself.

The theoretical downside of high T cell numbers is that high numbers might also reflect a high level of activation. In different settings (ie no IL-2) high levels of activation are associated with increased viral load and increased T cell turnover. With HAART, activation levels return to normal. As the research on IL-2 is evolving, the general feeling at this point is that IL-2 use with HAART is safe. Without HAART, there appears to be a risk of increased viral load.

Hope this helps, since it is not a very precise answer.

ATP



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